痛风性关节炎病人血清免疫球蛋白水平与疼痛的相关性研究
|
摘要
目的:分析痛风性关节炎(gouty arthritis, GA)病人血清免疫球蛋白及其亚型的变化以及与痛风活动程度的相关性。方法:收集中日友好医院2018年9月至2019年1月期间痛风性关节炎病人(GA组,n=101)和健康志愿者对照组(NC组,n=101)的临床资料及血清样本,采用免疫比浊法测定血清免疫球蛋白及其亚型水平,用SPSS统计软件对病人血清免疫球蛋白及其亚型与炎性因子、尿酸水平、疾病活动度等指标进行相关性分析。结果:GA病人血清IgA、IgM、IgE、C反应蛋白(reactive protein,CRP)水平与对照组相比显著升高(P <0.05);总IgG、IgG1、IgG3、IgG4水平与对照组相比显著降低(P <0.05)。GA病人急性期血清IgM、IgA、IgE、CRP水平、VAS评分与缓解期相比显著升高(P <0.05);相关性分析示:视觉模拟评分法(visual analogue scale, VAS)评分与血清IgE、IgM、CRP水平呈正相关(P<0.05),与尿酸(uricacid,UA)及其他所选实验室指标无显著相关性(P>0.05)。结论:GA病人血清IgM、IgA、IgE水平显著升高,可能参与了GA的发病。
Objective: This paper aims to analyze the changes of serum immunoglobulin and its subtypes in patients with gouty arthritis(GA) and the correlation between the levels of serum immunoglobulin(group GA, n = 101) and the activity of gouty arthritis. Methods: Clinical data and serum samples of gouty arthritis patients and healthy volunteers(group NC, n = 101) in China-Japan Friendship Hospital were collected from September 2018 to January 2019. The levels of serum immunoglobulin and its subtypes were measured by immunoturbidimetry method. SPSS statistical software was used to compare the differences in immunoglobulin levels between the two groups and the correlations between the serum immunoglobulin and the disease activity were analyzed. Results: The levels of serum IgA, IgM,IgE and C reactive protein(CRP) in patients with GA were significantly higher than those in the control group(P < 0.05), while the levels of total IgG, IgG1, IgG3 and IgG4 were significantly lower than those in the control group(P < 0.05). The levels of serum IgM,IgA,IgE, CRP and VAS in patients with GA in acute stage were significantly higher than those in remission stage(P < 0.05); correlation analysis showed that visual analogue scale(VAS) scores were positively correlated with serum IgE, IgM, CRP(P < 0.05), but not with uric acid(UA) and other biomarkers(P > 0.05). Conclusion: Serum IgM, IgA and IgE levels in patients with GA are significantly increased, and they may be involved in the pathogenesis of GA.
Objective: This paper aims to analyze the changes of serum immunoglobulin and its subtypes in patients with gouty arthritis(GA) and the correlation between the levels of serum immunoglobulin(group GA, n = 101) and the activity of gouty arthritis. Methods: Clinical data and serum samples of gouty arthritis patients and healthy volunteers(group NC, n = 101) in China-Japan Friendship Hospital were collected from September 2018 to January 2019. The levels of serum immunoglobulin and its subtypes were measured by immunoturbidimetry method. SPSS statistical software was used to compare the differences in immunoglobulin levels between the two groups and the correlations between the serum immunoglobulin and the disease activity were analyzed. Results: The levels of serum IgA, IgM,IgE and C reactive protein(CRP) in patients with GA were significantly higher than those in the control group(P < 0.05), while the levels of total IgG, IgG1, IgG3 and IgG4 were significantly lower than those in the control group(P < 0.05). The levels of serum IgM,IgA,IgE, CRP and VAS in patients with GA in acute stage were significantly higher than those in remission stage(P < 0.05); correlation analysis showed that visual analogue scale(VAS) scores were positively correlated with serum IgE, IgM, CRP(P < 0.05), but not with uric acid(UA) and other biomarkers(P > 0.05). Conclusion: Serum IgM, IgA and IgE levels in patients with GA are significantly increased, and they may be involved in the pathogenesis of GA.
引文
[1]菲尔斯坦.凯利风湿病学[M].栗占国,唐福林,译.第1版.北京:北京大学医学出版社,2015:1665-1675.
[2]彭英,彭兴甫,高强,等.超声引导下踝关节神经阻滞术在痛风性关节炎中的临床应用[J].中国疼痛医学杂志,2018,24(6):472-474.
[3]武东,赵金霞,孙琳,等.痛风炎症机制的研究进展[J]中华风湿病学杂志,2014,18(2):128-130.
[4]Kanevets U,Sharma K,Dresser K,et al.A role of IgMantibodies in monosodium urate crystal formation and associated adjuvanticity[J].J Immunol,2009,182(4):1912-1918.
[5]高万露,汪小海.视觉模拟疼痛评分研究的进展[J]医学研究杂志,2013,42(12):144-146.
[6]Neogi T,Jansen TL,Dalbeth N,et al.2015 Gout Classification criteria:an American College of Rheu-matology/European League Against Rheumatism collaborative initiative[J].Ann Rheum Dis,2015,74(10):1789-1798.
[7]Ma CA,Leung YY.Exploring the Link between Uric Acid and Osteoarthritis[J].Front Med,2017,4:225.
[8]Suresh R,Chandrasekaran P,Sutterwala FS,et al Complement-mediated'bystander'damage initiates host NLRP3 inflammasome activation[J].J Cell Sci,2016,129(9):1928-1939.
[9]万春平,李兆福,徐翔峰,等.急性痛风性关节炎免疫学发病机制研究进展[J].风湿病与关节炎,20121(4):52-55.
[10]Allaeys I,Rusu D,Picard S,et al.Osteoblast retraction induced by adherent neutrophils promotes osteoblast bone resorption:implication for altered bone remolding in chronic gout[J].Lab Invest,2011,91(6):905-920.
[11]Kaneko K,Iwamoto H,Yasuda M,et al.Proteomic analysis to examine the role of matrix proteins in a goutytophus from a patient with recurrent gout[J]Nucleos Nucleot Nucl Acids,2014,33(4-6):199-207.
[12]Akahoshi T.Pathological mechanisms of gouty arthritis[J].Nippon Rinsho,2008,66(4):705-710
[13]宋倩,刘健,忻凌,等.基于关联规则挖掘痛风性关节炎中医内外合治对病人免疫、炎症等指标的影响[J]风湿病与关节炎,2017,6(1):9-13,35.
[2]彭英,彭兴甫,高强,等.超声引导下踝关节神经阻滞术在痛风性关节炎中的临床应用[J].中国疼痛医学杂志,2018,24(6):472-474.
[3]武东,赵金霞,孙琳,等.痛风炎症机制的研究进展[J]中华风湿病学杂志,2014,18(2):128-130.
[4]Kanevets U,Sharma K,Dresser K,et al.A role of IgMantibodies in monosodium urate crystal formation and associated adjuvanticity[J].J Immunol,2009,182(4):1912-1918.
[5]高万露,汪小海.视觉模拟疼痛评分研究的进展[J]医学研究杂志,2013,42(12):144-146.
[6]Neogi T,Jansen TL,Dalbeth N,et al.2015 Gout Classification criteria:an American College of Rheu-matology/European League Against Rheumatism collaborative initiative[J].Ann Rheum Dis,2015,74(10):1789-1798.
[7]Ma CA,Leung YY.Exploring the Link between Uric Acid and Osteoarthritis[J].Front Med,2017,4:225.
[8]Suresh R,Chandrasekaran P,Sutterwala FS,et al Complement-mediated'bystander'damage initiates host NLRP3 inflammasome activation[J].J Cell Sci,2016,129(9):1928-1939.
[9]万春平,李兆福,徐翔峰,等.急性痛风性关节炎免疫学发病机制研究进展[J].风湿病与关节炎,20121(4):52-55.
[10]Allaeys I,Rusu D,Picard S,et al.Osteoblast retraction induced by adherent neutrophils promotes osteoblast bone resorption:implication for altered bone remolding in chronic gout[J].Lab Invest,2011,91(6):905-920.
[11]Kaneko K,Iwamoto H,Yasuda M,et al.Proteomic analysis to examine the role of matrix proteins in a goutytophus from a patient with recurrent gout[J]Nucleos Nucleot Nucl Acids,2014,33(4-6):199-207.
[12]Akahoshi T.Pathological mechanisms of gouty arthritis[J].Nippon Rinsho,2008,66(4):705-710
[13]宋倩,刘健,忻凌,等.基于关联规则挖掘痛风性关节炎中医内外合治对病人免疫、炎症等指标的影响[J]风湿病与关节炎,2017,6(1):9-13,35.